sarcoidosis Flashcards
what is sarcoidosis?
Sarcoidosis is a multisystem granulomatous disorder of unknown aetiology.
characterised by non-caseating granulomas. It is more common in young adults and in people of African descent
what are the features of sarcoidosis?
acute: erythema nodosum, bilateral hilar lymphadenopathy, swinging fever, polyarthralgia, dactylitis
insidious: dyspnoea, non-productive cough, malaise, weight loss, anorexia
skin: lupus pernio
hypercalcaemia: macrophages inside the granulomas cause an increased conversion of vitamin D to its active form (1,25-dihydroxycholecalciferol)
what are the syndromes associated with sarcoidosis?
lofgren’s syndrome
mikulicz syndrome
heerfordts syndrome
what is lofgren’s syndrome?
a form of sarcoidosis characterised by:
bilateral hilar lymphadenopathy BHL
erythema nodosum
fever
polyarthralgia
excellent prognosis
what is mikulicz syndrome?
enlargement of parotid + lacrimal glands due to sarcoidosis, tuberculosis or lymphoma
unhelpful as confusing overlap with sjogrens syndrome
what is heerfordt’s syndrome?
uveoparotid fever
there is paratod enlargement, fever + uveitis secondary to sarcoidosis
what are the features of acute sarcoidosis?
erythema nodosum
fever
polyarthralgia
bilateral hilar lymphadenopathy
GRAULOMAS
what are general features of sarcoidosis?
Fever
Anorexia and ↓ wt.
Fatigue
Lymphadenopathy and HSM
what are respiratory causes of sarcoidosis?
Upper: otitis, sinusitis
Lower (seen in 90%)
Dry cough, SOB, chest pain, ↓ lung function
Stage 1: BHL
Stage 2: BHL + peripheral infiltrates
Stage 3: Peripheral infiltrates alone
Stage 4: Progressive mid-zone fibrosis ̄c bullae
what are the joint features of sarcoidosis?
polyarthraliga
dactylitis
what are the neurological features of sarcoidosis?
Peripheral and cranial polyneuropathy (esp. Bell’s palsy)
Meningitis, transverse myelitis, SOL
what are the renal features of sarcoidosis?
hypercalcaemia leads to
renal stones, nephrocalcinosis, DI
what are hormonal features of sarcoidosis?
pituitary dysfunction eg amenorrhoea
what are ophthalmological features of sarcoidosis?
uveitis
keratoconjunctivitis
sicca/mikulicz/sjogrens syndrome
what are cardiac features of sarcoidosis?
restrictive cardiomyopathy secondary to granulomas + fibrosis
pericardial effusion